Abstract

A nation-wide SCI survey was conducted for the first time in Saudi Arabia. It showed that the current situation and characteristic features of SCI patients was significantly different from that in other countries and there is deficiency in medical and rehabilitation services provided for the treatment of this condition. The incidence rate of SCI in Saudi Arabia exceeded all values reported from other countries. The survey showed that the incidence of fracture in long bones was also comparatively high.
In spite of the high rate of fractures occurring around the knee joint in chronic SCI patients, no specific study has been carried out measure bone mineral density (BMD) values of this site. Therefore, as part of this research BMD was measured at different sites in the skeleton using Dual Energy X-ray Absorptiometry (LUNAR). This included measurement at seven regions around the knee joint in both Saudi SCI patients and able-bodied subjects using modified Lunar Software. This study demonstrated that BMD around the knee joint, particularly the femoral supracondyle, was more powerful predictor of the risk of fractures occurring in long bones of SCI individuals than measurement at the proximal femur. Utilising this data, new diagnostic criteria were development to identify patients at risk of these fractures.
Functional Electrical Stimulation techniques were used for the first time in Saudi Arabia to restore upright locomotion using the Parastep® system. The ambulatory performance of subjects in this study was similar to that in other studies world-wide. There were some shortcomings observed with the system, which negatively affected walking parameters. Those shortcomings were presented and discussed in this thesis with appropriate recommendations on how they might be overcome